title: Follicular-fluid anti-Mullerian hormone (FF AMH) is a plausible biochemical indicator of functional viability of oocyte in conventional in vitro fertilization (IVF) cycles.
abstract: BACKGROUND
  Oocyte quality may be a governing factor in influencing in vitro fertilization (IVF) outcomes. However, morphological evaluation of oocyte quality is difficult in conventional IVF cycles. Follicular-fluid (FF), the site for oocyte growth and development, has not yet been sufficiently explored to obtain a marker indicative of oocyte quality. Anti-Mullerian hormone (AMH) is produced by granulosa cells of preantral and early-antral follicles and is released in FF.
  
  
  OBJECTIVE
  To investigate AMH as a biochemical indicator of functional viability/quality of oocyte produced in the FF micro-environmental milieu.
  
  
  METHODS
  Prospective study involving 132 cycles of conventional IVF-embryo transfer (ET) in infertile women.
  
  
  METHODS
  AMH concentration was estimated in pooled FF on day of oocyte pickup. Cycles were sorted into low and high groups according to median (50 (th) centile) values of measurement. Main outcome measure was oocyte viability, which included morphological assessment of oocyte quality, fertilization rate, clinical pregnancy, and implantation rates.
  
  
  METHODS
  Graph-pad Prism 5 statistical package.
  
  
  RESULTS
  Low FF AMH group shows significantly higher percentage of top-quality oocytes (65.08 ± 24.88 vs. 50.18 ± 25.01%, P =0.0126), fertilization (83.65 ± 18.38 vs. 75.78 ± 21.02%, P =0.0171), clinical pregnancy (57.57 vs. 16.67%, P >0.0001), and embryo implantation rates (29.79 vs. 7.69%, P >0.0001) compared to high FF AMH group. FF AMH shares an inverse correlation with FF E2 (Pearson r = -0.43, r(2) = 0.18) and clinical pregnancy (Pearson r = -0.46, r(2) = 0.21). Threshold value of FF AMH for pregnancy is >1.750 ng/mg protein.
  
  
  CONCLUSIONS
  FF AMH is a plausible biochemical indicator of functional viability of oocyte in conventional IVF cycles.
authors.affiliation: Department of Embryology and Biochemistry Research Laboratory, Vaunshdhara Clinic and Assisted Conception Centre, Nagpur, Maharashtra, India.
authors.forename: Bindu N
authors.initials: BN
authors.lastname: Mehta
authors.forename: Meena N
authors.initials: MN
authors.lastname: Chimote
authors.forename: Nishad N
authors.initials: NN
authors.lastname: Chimote
authors.forename: Nirmalendu M
authors.initials: NM
authors.lastname: Nath
authors.forename: Natachandra M
authors.initials: NM
authors.lastname: Chimote
keywords: FF AMH; IVF; functional viability of oocyte; implantation rate; oocyte quality